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Whip Worm

Birdie birdies at ix.netcom.com
Fri Oct 31 22:28:11 EST 1997


Richard Speare wrote:
> 
> Dear Birdie
> 
> On Fri, 31 Oct 1997, Birdie wrote:
> 
> > Hi,
> >
> > A friend of mine acquired a whip worm infestation from, she
> > thinks, eating a peach from Chile that she failed to wash before
> > ingesting.
> 
> The infection you refer to as whip worm seems more of a problem than I
> would have expected.  Are you talking about Trichuris trichiura?  This
> nematode parasite is usually not difficult to eradicate in travellers
> once they have returned home.

Yes, it is Trichuris...
 
> To clarify the case, one has to be systematic. Can I ask you some
> questions:
> 
> 1. Was the diagnosis made by finding eggs of Trichuris trichiura in
> faeces?  If the diagnosis was not made by finding eggs in faeces or by
> finding the adult worm, I would consider that the diagnosis of "whip worm"
> is very unreliable.

Adult worms, bloody stool, eggs. Reliable.

> 2. Assuming the diagnosis has been made from finding the parasite, the
> next step is to kill the worms, usually with mebendazole 100 mg twice a
> day for 3 days.

They've been giving her the common different medications for over a year.
The most recent is the most powerful, and they are getting immune and/or
are fortified in a pocket/obstruction. They've in short, survived it all.
 
> 3. The course of infection is monitored by repeating faecal
> examinations. One would expect that in most cases a single course of
> therapy would be 100% effective in eradicating the infection in a patient
> in a non-endemic area. Test faeces perhaps 1 week after therapy, and if
> negative, again in 2 months.

The course of action now, meication having faile, is they want  to do
surgery to scrape her bowels out. Have you hear of this? It sounds
terribly extreme to me, and, you will recognise how this is a last
ditch - all else failed effort. 

Except, the herbal remedies haven't been tried yet.

> 4. Monitoring of the effect of therapy on the worm should not be done by
> following changes in clinical signs. This is a totally different aspect
> since clinical signs may be due to factors other than the presence of whip
> worm.

This is an interesting point. I have a concern of my own that
perhaps her abdominal pain could be a result of a obstruction
caused by *deceased* whipworms. However, tests have shown
that they are still alive - could be a combination.

Wouldn't an obstruction caused by dead whipworms cause
more problems than simply abdominal pain?

> Hope this helps.

Thanks!!! I'm getting abit concerned at this point.

Birdie



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